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目的经尿道前列腺电切术(TURP)是处理良性前列腺增生(BPH)引起下尿路梗阻症状的最好方式,然而,术后仍一定数量患者的膀胱过度活动综合征(OAB)症状未见缓解,探讨良性前列腺增生电切术后并发膀胱过度活动综合征的影响因素具有非常重要的意义。方法收集丽水市中心医院2011年6月—2014年6月收治的BPH患者286例的临床资料,患者均行TURP治疗,单因素对比分析2组患者的前列腺体积、残余尿量、平均尿流率、最大尿流率、逼尿肌稳定性、国际前列腺症状评分(IPSS)、生活质量评估(QOL)评分、泌尿系感染、尿潴留等,并进一步行多因素非条件Logistic回归分析前列腺增生电切术后并发膀胱过度活动综合征的影响因素。结果所有患者均顺利行TURP术,术后OAB症状未缓解的共有42例(观察组),OAB症状缓解的共有244例(对照组),通过对比分析2组患者观察指标结果提示,与对照组患者相比,观察组患者前列腺体积更大,残余尿量更多,最大尿流率更小,逼尿肌稳定性更差及IPSS评分更高,差异有统计学意义(P<0.05)。应用多因素非条件Logistic回归分析结果显示,术前患者更小的最大尿流率、更差的逼尿肌稳定性及更高的IPSS评分显著增加TURP术后OAB症状的风险(P<0.05)。结论 TURP术后并发OAB症状与患者最大尿流率、逼尿肌稳定性及IPSS评分相关,应积极控制风险因素,以提高患者生活质量并改善预后。
Objective TURP is the best way to manage the symptoms of lower urinary tract obstruction due to benign prostatic hyperplasia (BPH). However, the number of overactive bladder syndrome (OAB) remained unchanged after a certain number of postoperative patients , To explore the impact of benign prostatic hyperplasia complicated with overactive bladder complicated with the impact of factors is of great significance. Methods The clinical data of 286 BPH patients admitted from June 2011 to June 2014 in Lishui Central Hospital were collected and treated with TURP. Prostatic volume, residual urine volume and mean urinary flow rate were compared between two groups by single factor analysis , Maximum uroflow rate, detrusor stability, IPSS, QOL score, urinary tract infection, urinary retention and so on. Further, Multivariate non-conditional Logistic regression was used to analyze the relationship between BPH Influencing factors of postoperative overactive bladder syndrome. Results TURP was performed successfully in all the patients. Twenty-four patients (observation group) were not relieved of OAB symptoms and 244 patients (OGT) were relieved of OAB symptoms. The results of observation of the two groups of patients showed that compared with the control group Patients in the observation group had larger prostate volume, more residual urine volume, smaller maximum uroflow rate, poorer detrusor stability and higher IPSS score in the observation group (P <0.05). Multivariate non-conditional logistic regression analysis showed that the smaller maximum flow rate, the worse detrusor muscle stability and the higher IPSS score in preoperative patients significantly increased the risk of OAB symptoms after TURP (P <0.05) . Conclusions OAB symptoms after TURP complicated with maximal uroflow rate, detrusor stability and IPSS score should be positively controlled in order to improve quality of life and improve prognosis of patients.